NI is key to a new deal with the public over NHS

10 January 2018

Sir,

The political debate on how best to gain the country’s approval for a new health and social care funding settlement is, as documented by Janan Ganesh, at a critical stage (“The case for a special NHS tax”, January 9).

Supported by a cross-party group of MPs, Sir Oliver Letwin and I are attempting to build a lifeboat for the British government. A motion we tabled before Christmas recommended that the immediate financial challenge should be met by raising additional hypothecated funds; and the long-term challenge should be met by reforming both the national insurance contributory base and local precepts along progressive lines to fund a National Health and Social Care Service.

The use of NI contributions, rather than income tax, is crucial to striking this new deal with the public. Polling last year found that while 42 per cent of the public would support an increase in tax to pay for a larger National Health Service budget, this figure climbs 11 points, to 53 per cent, once the public are asked about an increase in NI contributions.

Moreover, the creation of a new mutual with three functions — to both receive and manage the hypothecated funds, deliver a more efficient service, and engage with the public on the contribution levels required to deliver a world-class service — would reassure the public that their contributions are going directly towards a health and social care system that is fit for the next generation.